Individual
DIAMOND MUNGROO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
97 HEFNER ST, EAST ELLIJAY, GA 30540-8268
(706) 635-1440
Mailing address
316 PLANTATION CIR, FAYETTEVILLE, GA 30214-5407
(404) 901-5755
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017813
GA
2255A2300X
Athletic Trainer
AT004177
GA
Other
Enumeration date
06/09/2020
Last updated
01/03/2026
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